Inferior corneal decompensation following laser peripheral iridotomy in the superior iris

PURPOSE: To describe a previously unreported clinical entity of inferior corneal decompensation occurring as a long-term complication of superior laser peripheral iridotomy. DESIGN: Retrospective, noncomparative observational case series. METHODS: Chart review of 14 subjects (16 eyes) with inferior corneal decompensation. RESULTS: All patients were Chinese, most were females (71.4%), and the mean age was 69.5 +/- 8.1 year. The mean interval from iridotomy to the onset of inferior corneal decompensation was 66.1 +/- 34.0 months. The most common indication for laser iridotomy was for prophylaxis, either in the fellow eye of acute angle closure (43.8%) or for occludable angles (12.5%). CONCLUSIONS: Corneal decompensation in the inferior part of the cornea at a site remote from the iridotomy is a rare but important complication of laser iridotomy. Because many of the laser iridotomies were performed prophylactically in eyes without glaucoma, patients may need to be warned of this risk.